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REFERRAL SPECIALIST - TEXOMA CARE

Texoma Medical Center Denison, TX Full-Time
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One of the nation’s largest and most respected hospital companies, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Steadily growing from a startup to an esteemed Fortune 500 corporation, UHS today has annual revenue nearing $10 billion. In 2017, UHS was recognized as one of the World’s Most Admired Companies by Fortune; ranked #276 on the Fortune 500, and listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies.

Our operating philosophy is as effective today as it was 40 years ago: Build or acquire high quality hospitals in rapidly growing markets, invest in the people and equipment needed to allow each facility to thrive, and become the leading healthcare provider in each community we serve.

Headquartered in King of Prussia, PA, UHS has more than 81,000 employees and through its subsidiaries operates more than 320 acute care hospitals, behavioral health facilities and ambulatory centers in the United States, Puerto Rico, the U.S. Virgin Islands and the United Kingdom.

Texoma Medical Center, a 351-bed acute care facility has been providing quality health care to the residents of North Texas and Southern Oklahoma since 1965. Our main campus is located in Denison, Texas, approximately one hour north of the Dallas/Fort Worth area and just south of the Texas/Oklahoma border. In addition, we have numerous facilities in locations throughout the Texoma region.

Since 1965, TMC has forged a special relationship with the people of North Texas and Southern Oklahoma. Texoma residents have come to depend on TMC to meet a spectrum of physical, mental and spiritual needs. TMC has responded with unique services to provide the kind of sophisticated, experienced care that was once was available only in major metropolitan areas.

We offer major specialty services including open heart surgery and neurosurgery. Advanced resources such as certified trauma care support TMC's role as a regional specialty center.

Position Summary: Responsible for scheduling referrals for patients, providers, pre-authorizing & pre-certing tests/procedures. Scheduling of other tests with facilities at the request of providers and/or staff. Directly communicates with the clinics, referred to clinics, and patients. Reviews clinical data to report medical necessity to insurance companies. Performs all work with accord to the mission, vision and values of the practice.

Job Requirements

Education: • High school graduate or GED required.  

Work experience: Minimum of two years’ experience in a healthcare or clinical setting.

Knowledge: 

        • Knowledge of clinical terminology, insurance billing, procedural and diagnosis coding, federal and state insurance

          regulations and HIPAA privacy standards is strongly preferred.

• Typing, 10 key and computer skills required.

• Proficiency in Microsoft Office applications required.

• Required effective interpersonal skills and excellent written, oral communication skills required.

• Acute healthcare knowledge and ability to evaluate clinical data to acquire pre-authorizations and referrals is preferred. Knowledge of third party reimbursement regulations is preferred.

• Patient Management, Billing and Managed Care system processes competency. Understanding of functions and work flow of Clinical/Hospital departments.

• Excellent planning and organizational skills. Demonstration of strong analytical skills and problem-solving abilities. Strong teamwork skills and the ability to effectively communicate with all management levels.

• Results oriented, independently goal directed, able to multi-task and meet established time frames.

        • Excellent customer service skills and must be able to work independently.

 

Recommended skills

Analytical
Computer Literacy
Coordinating
Communication
Team Working
Scheduling
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Job ID: 107438

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